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Animal-assisted therapy: is it undervalued as an alternative treatment?

"A pet is an island of sanity in what appears to be an insane world. Friendship retains its traditional values and securities in one's relationship with one's pet. Whether a dog, cat, bird, fish, turtle, or what have you, one can rely upon the fact that one's pet will always remain a faithful, intimate, non-competitive friend, regardless of the good or ill fortune life brings us."

If you are an animal lover, you will fully relate to this quote from American child psychologist Dr. Boris Levinson. And it seems the majority of us are. As of 2012, 62% of American households included at least one pet.

There is no doubt that humans have a strong bond with animals, and it is this bond that led to the introduction of animal-assisted therapy (AAT), or pet therapy - the idea that animals can help humans cope with or recover from certain medical conditions.

In fact, it was Dr. Levinson who first came up with the idea of AAT in the 1960s, after finding that he was better able to reach a withdrawn 9-year-old boy every time his dog - called Jingles - was in the room with him. With Jingles present - who Dr. Levinson deemed his "co-therapist" - he found he was able to gain the trust of the boy, something that past therapists had failed to do.

In 1961, Dr. Levinson presented the idea of AAT to the American Psychological Association (APA). At the time, the theory was met with cynicism. But a survey conducted by Dr. Levinson 10 years later found that of 319 psychologists, 16% used companion animals in their therapy sessions, indicating that people were warming to the idea of AAT.

Today, AAT is more popular than ever. A 2011 report from the US Department of Health and Human Services, the Centers for Disease Control and Prevention (CDC) and the National Health Center for Health Statistics revealed that almost 60% of hospice care providers that provide complementary and alternative therapies offer pet therapy to patients.

What is AAT?

AAT is an intervention that uses animal interaction to aid recovery from health problems or to help people cope with certain medical conditions.

The therapy is believed to have an array of benefits, including personal and social development, increased self-esteem, improved mental health, better social skills and increased empathy and nurturing skills.

AAT is believed to assist personal and social development, increase self-esteem, improve mental health, boost social skills and increase empathy and nurturing skills.

Study co-author Holly Dabelko-Schoeny, associate professor of social work at Ohio State, said of the findings:

"We wanted to test whether people with dementia could have positive interactions with horses, and we found that they can - absolutely. The experience immediately lifted their mood, and we saw a connection to fewer incidents of negative behavior."

Individuals with physical disabilities may also benefit from AAT. Equine therapy, which can also involve horse riding, has been shown to improve patients' strength, flexibility and balance.

AAT is not just limited to interaction with cats, dogs and horses; it can include everything from hedgehogs, rabbits and skunks, to snakes and even spiders. Critterish Allsorts - an AAT practice based in the UK - use a tarantula called Fluffy as a therapy for individuals with autism.

In the past, concerns have been raised regarding the safety and sanitation of AAT, particularly if such therapy is conducted in hospitals. However, rules are put in place to ensure animals are well trained, clean and vaccinated. To date, the CDC have received no reports of infection through AAT.

How does AAT work?

In general, the benefits of AAT stem from the interaction with animals. Some forms of AAT, such as equine therapy, involve caring for animals on a regular basis. For example, equine therapy may require individuals to feed, groom and bathe horses once or twice a week.

"The exposure to the animals may result in higher levels of engagement and fewer problematic behaviors, which may make caring for the person with the disease easier.

In addition, AAT 'opens the world up' for individuals with Alzheimer's disease and other dementias. It is not uncommon for persons with dementia to have their world shrink down to just addressing basic human needs, and having relationships with animals can provide them with stimulation and something to think about and talk about with others."

Other forms of AAT may include an animal being brought to a care facility for patient interaction. For example, Pet Partners - a non-profit organization in the US that provides AAT - has a volunteer who brings a cat to a rehabilitation center to work with an occupational therapist and a child who has problems with movement. The occupational therapist asks the child to handle the cat's collar, or open a tin of treats and feed the cat - activities that help improve the child's motor skills.

"Animal-assisted activities can provide much needed motivation, education or recreation to enhance a person's quality of life," Mary Craig, CEO of the Pet Partners board and a veterinarian, told Medical News Today.

Should there be more focus on the use of AAT?

But Craig notes an important point:

"It's easy for our volunteers involved in animal assisted activities to see and understand the benefits to animal-assisted activities. But the magic that happens in these interactions is difficult to quantify and 'prove.' The benefits realized are often unique to the individuals involved in the personal exchanges."

Because of this, many experts in the AAT field believe the therapy is undervalued and that there should be more research conducted to expose its benefits.

"There is a growing body of research, but much of it is still qualitative, not quantitative," Chris Patella, of Animal Assisted Therapy Services - a US organization that specializes in equine and canine therapy - told us.

"We need hard numeric data to convince insurance companies and legislatures that AAT should be covered like any other medical intervention."

In addition, Patella said he believed that doctors should be recommending AAT as an alternative treatment for patients with both physical and mental health conditions.

"However," he added, "doctors are rooted in Western medicine that promotes medication. They, too, are looking for the solid research that proves AAT is a viable intervention. Research is the key."

Could AAT replace drug treatment?

This brings us to the question of whether AAT could replace or reduce the use of drug treatment for certain health conditions.

A 2009 study from Loyola University in Chicago, IL, found that adults who used AAT - in the form of canine therapy - while recovering from total joint-replacement surgery required 50% less pain medication.

Dr. Edward Creagan, an oncologist at the Mayo Clinic in Rochester, MN, is one health professional who feels very strongly about the health benefits of pets, to the extent that he notes the name of a patient's pet when he takes their medical history.

"A pet is a medication without side effects that has so many benefits," he says. "I can't always explain it myself, but for years now I've seen how instances of having a pet is like an effective drug. It really does help people."

Dr. Creagan talks more about his belief in the health benefits of animals in the video below:

But Dabelko-Schoeny told us that when it comes to certain conditions, such as Alzheimer's, AAT is unlikely to replace the use of medication - though it may be useful accompaniment:

"The question is, do we have sufficient evidence to warrant financial reimbursement for such services? Will animal-assisted therapy lead to longer life or reduced emergency department visits and rehospitalizations? Probably not. But animal assisted therapy may increase patients' quality of life."

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